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Frequently Asked Questions (FAQs)

How many infants born in the United States are breastfed?

The CDC National Immunization Survey is a nationally representative sample of the U.S. population that provides the percent of U.S. children who are breastfed by birth year. Rates are provided on breastfeeding initiation, duration, and exclusivity.

Are growth charts available to assess growth in breastfed infants?

In the United States, the 2006 WHO growth standard charts are recommended for use with both breastfed and formula fed infants and children, from birth to aged 2 years to monitor growth.1 The WHO growth charts reflect growth patterns among children who were predominantly breastfed for at least 4 months and still breastfeeding at 12 months. These charts describe the growth of healthy children living in well-supported environments in six countries throughout the world including the United States. The WHO growth charts show how infants and children should grow rather than simply how they do grow in a certain time and place and are therefore recommended for all infants. The WHO growth charts are relevant to the U.S. infant and young child population as U.S. children were included in the WHO study sample and their growth tracks along the median of the pooled international sample.2-3

The WHO growth charts establish the growth of the breastfed infant as the norm for growth. Healthy breastfed infants typically put on weight more slowly than formula fed infants in the first year of life.4-5 Formula fed infants gain weight more rapidly after about 3 months of age. Differences in weight patterns continue even after complementary foods are introduced.4

The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend that health care providers in primary care settings use the 2000 CDC growth reference charts for children and teens aged 2 to 20 years to monitor growth in the United States. 1 The 2000 CDC growth reference charts include the weight-for-age, stature-for-age, and BMI (Body Mass Index)-for-age charts for boys and girls aged 2 to 20 years.

When should a baby start eating solid foods such as cereals, vegetables, and fruits?

Breast milk alone is sufficient to support optimal growth and development for approximately the first 6 months after birth. For these very young infants, the American Academy of Pediatrics (AAP) states that water, juice, and other foods are generally unnecessary. Even when babies enjoy discovering new tastes and textures, solid foods should not replace breastfeeding, but merely complement breast milk as the infant's main source of nutrients throughout the first year. Beyond one year, as the variety and volume of solid foods gradually increase, breast milk remains an ideal addition to the child's diet.

How long should a mother breastfeed?

The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond.

What can happen if someone else's breast milk is given to another child?

HIV and other serious infectious diseases can be transmitted through breast milk. However, the risk of infection from a single bottle of breast milk, even if the mother is HIV positive, is extremely small. For women who do not have HIV or other serious infectious diseases, there is little risk to the child who receives her breast milk. See Diseases and Conditions for more information.

Are special precautions needed for handling breast milk?

CDC does not list human breast milk as a body fluid for which most healthcare personnel should use special handling precautions. Occupational exposure to human breast milk has not been shown to lead to transmission of HIV or HBV infection. However, because human breast milk has been implicated in transmitting HIV from mother to infant, gloves may be worn as a precaution by health care workers who are frequently exposed to breast milk (e.g., persons working in human milk banks).

For additional information regarding Universal Precautions as they apply to breast milk in the transmission of HIV and Hepatitis B infections, visit the following resources:

Should mothers who smoke breastfeed?

Mothers who smoke are encouraged to quit, however, breast milk remains the ideal food for a baby even if the mother smokes. Although nicotine may be present in breast milk, adverse effects on the infant during breastfeeding have not been reported. AAP recognizes pregnancy and lactation as two ideal times to promote smoking cessation, but does not indicate that mothers who smoke should not breastfeed.

Where can I find answers to my other questions about breastfeeding?

To locate someone who can help you with practical breastfeeding concerns, begin by talking to your pediatrician. In addition, you may wish to contact your State or County Health Department, your local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic, or one of the local La Leche League affiliates. To locate a Board Certified Lactation Consultant (IBCLC), visit The International Lactation Consultant Association.

References

1Grummer-Strawn LM, Reinold C, Krebs NF; Centers for Disease Control and Prevention. Use of the World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR Recomm Rep. 2010;59(RR-9);1-15. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5909a1.htm. Accessed April 24, 2013.